A Few Quick Questions

I've just been listening to Joe Biden - just back from vacation, while his disastrously executed withdrawal from Afghanistan went horrifically pear-shaped, making Saigon look like a foreign policy success - speaking to the American people in defense of his decision to withdraw.

For his liberal apologistas, yes, I know - President Trump planned to withdraw, too. I'm not saying that withdrawal is the wrong decision. I'm not saying we ever should have been there in the first place. (Note that Biden wasn't calling for his boss to withdraw during the eight years that he supposedly had his ear.)

My problem isn't so much with the what, but with the how. Biden said it wouldn't end like Saigon.

It didn't. In Saigon, we didn't see images of desperate Vietnamese hanging onto C-130s as they rolled down the tarmac, then plunging to their deaths as the planes went airborne - knowing as they fell that their fate would be preferable to what they faced at the hands of the Taliban.

Biden didn't anticipate the country falling so fast that he'd have to send troops back in to evacuate our embassy, that the fall of Kabul would be so fast that even that operation would be so late that he'd have to beg the Taliban to spare our people. That the translators who've helped us while we were in country will be mercilessly tortured and executed, because we can't get them out. That he's handing the country over to China. His pull-out was more sloppy than a frantic teenager in the backseat of Dad's car.

We all know that stupid stuff comes out of Joe's mouth like poop comes out of a baby, but I found four of his comments particularly curious, and I wish I could question him about each of them. Instead, I'll just point them out here, and question them rhetorically.

First, (and these are in no particular order in terms of when he said them during his speech, which isn't important anyway, since he rambles like a drunken gnat), he said that the Afghan political leaders couldn't come together.

Am I the only one who sees the irony in this?

Remember Joe's inaugural address? He was going to be the great uniter, the healer, the guy who brings the two sides together. Then he signed executive order after executive order, rather than trust the legislative process. He praised Republicans in a presser for their bipartisan support of a $1 trillion infrastructure deal, then immediately held another presser with Democrats crowing about how they were gonna use reconciliation to shove another $3.5 trillion in spending on the Socialist wing's agenda down the American people's throats.

When it comes to uniting, this guy is to America as Moses was to the Red Sea.

Second, he said that on a call a while back, prior to the withdrawal, he advised the Afghan President to clean up the corruption in his government.

Whaaaaat?

Again, does no one else see the irony in this? If you don't, Hunter would like to sell you a painting. Never mind that it'll look exactly like your kid's refrigerator art, but will cost you millions. That's assuming he has time to whip one up in between his Burisma board meetings, a gig daddy kept from being investigated by threatening to withhold aid from one of our allies.

Third, he seemed incredulous that we spent $1 trillion in Afghanistan. Over the last 20 years.

You have to see the irony in that. We've spent more than that in the last week.

Finally, he said, "I won't repeat the mistakes of the past 20 years."

Hey Joe, explain your border policy. Looks to me like you're not just repeating them, you're doubling down on them.

By the Numbers

The Curmudgeon does not like misinformation, no matter the source or the slant. He did not like it when covid cases and deaths were sensationalized through fuzzy reporting, or when the PCR cycle thresholds were set at high levels to increase positive test results. He especially hates it when fuzzy math is used to misinform, as it was with the positivity rate, or unemployment data last April and May.

So he is going to be equally deliberate in addressing misinformation fueled by bad math no matter what it relates to. In this post, it will relate to vaccine effectiveness. Specifically, claims that breakthrough infections show that vaccine effectiveness is low, or waning, or that the number of cases among the vaccinated is about the same as among the unvaccinated. But first, some disclaimers.

I am not a vaccine crusader. I have stated before my own fence-sitting position regarding the vaccines, and if and when that changes, I will keep it to myself. I will not proclaim my vaccination status on social media; if one derives one's virtue from having gotten a shot, one is rather devoid of virtue. The same is true if one has to signal one's virtues on social media in general.

I believe strongly that it is each individual's choice whether to get any vaccine: covid, influenza, shingles. (Although I do believe there is a special corner of the loony bin for those blanket anti-vaxxers who believe that childhood vaccines cause autism; as the grandfather of an exceptional child on the spectrum, I know better.) I do not believe in mandates, although as a free-market capitalist I defend the right of any business to make its own decisions regarding them. Just as I defend any consumer's or employee's right to make their own decisions regarding patronage or employment.

And I absolutely am opposed to vaccine shaming - the practice of using phrases like "what we have is a pandemic of the unvaccinated," or using the fact that the vast majority of infections are among the unvaccinated to attempt to marginalize those who have exercised their right to make their own health decisions, and not get a vaccine. Nobody tries to shame people who don't get the flu shot every season, and the flu kills a few hundred kids a year. (Spare me the false equivalencies over numbers.)

Now, on to the topic of this post. Amid the spikes in cases that we've seen from the spread of the Delta variant in the U.S., we've all seen the reports from doctors that "99% of infections are among the unvaccinated." Those, I believe, are indeed slanted toward the vaccine-shaming narrative; the more reasonable reports are probably those that say "97-99%," and that's likely even on the high side.

However, in recent days I've seen several articles floating around, reporting on breakthrough cases in various locations, and using bad math to imply that infections among the vaccinated are as common as among the unvaccinated. I'll look at each of these in turn, address the problems posed by the assumptions made and any conclusions offered, and explain the math that refutes the argument that cases among the vaccinated are equal to those among the unvaccinated. Finally, I'll present some verified statistics that support that math.

Provincetown, MA

Several sources reported a CDC finding that 74% of people infected in an outbreak stemming from several events and gatherings in Provincetown in July were fully vaccinated. (This, in part, was the basis for the CDC's ridiculous reversal of its mask guidance.) Provincetown sits at the tip of Cape Cod, and hosts a number of summer events.

However, here's what's important about the Provincetown data. First, the CDC study was based on a total of 469 covid cases that resulted from those events. That's 0.03% of the total covid cases in the U.S. in the month of July. So to extrapolate the Provincetown experience to the entire U.S, you'd have to multiply the Provincetown breakthrough infections by 3,333.33. In other words, given that there were 347 breakthrough infections of fully vaccinated individuals from the Provincetown events, that would mean that there were 1,156,866 breakthrough infections of fully vaccinated individuals in the U.S. in July. Don't you think that we'd have heard about that, were it true? Even if one is so predisposed to conspiracy theories as to believe that the mainstream media would bury such a story, consider that the mainstream media reported on the Provincetown study. At a minimum, Tucker Carlson of Fox News would have let us know if there were over a million breakthrough infections in July.

So the first thing the Provincetown case suffers from is the law of large (or in this case small) numbers. It just isn't statistically significant. It cannot be extrapolated.

The second thing that's noteworthy - and this is important, so pay attention, because this is the crux of the math behind all of these breakthrough reports - is that Massachusetts has the second-highest rate of vaccination among U.S. states, at more than 64% fully vaccinated. The highest vaccination rate in the state is on Cape Cod (other than the sparsely populated island communities), at 77% of the eligible population.

Why is this so important? Here's how the math works. Let's take it to the extreme and assume a hypothetical country (or state or county) where 100% of the population is vaccinated. At that point, every infection will be a breakthrough infection. But why will there be any infections at all, you ask? Because the vaccines' efficacy - their ability to prevent infection - is less than 100%. In trials and in actual experience since emergency use authorization was granted back in December 2020, the efficacy rate has been proven to be 90-95%. So 5-10% of those vaccinated could still get infected.

Now, if we back that off a bit, and take a place like Cape Cod, where the vaccination rate isn't 100%, but rather 77%, you're going to get some infections among unvaccinated people, and some breakthrough infections among vaccinated people. I'll provide a graphic below that neatly illustrates how this works, but for now, let's stick to the math.

So let's put a bunch of people, vaccinated and unvaccinated, together at some large events in Provincetown, all in close proximity. (Provincetown is a pretty small place.) If we assume that about 77% of them are vaccinated, in line with the Cape Cod vaccination rate, and we wind up with 74% of the people who wind up getting infected being fully vaccinated ... are you starting to see how the numbers might line up?

It's important to note that among those 347 breakthrough cases, 274 (79%) were symptomatic, four (1.2%) were hospitalized, and none died.

But another really important thing to note is that there will be fewer infections, the higher the vaccination rate. This also belies the notion that there would be no difference in cases between the vaccinated and the unvaccinated. We'll address that toward the end of the post.

Israel.

There's a video making the rounds on social media of an interview on Israeli TV of a doctor from a Jerusalem hospital talking about breakthrough infections there. The interview is in Hebrew, with subtitles also in Hebrew, but the video has English subtitles. I question the veracity of the English subtitles, because having searched all over the internet for the video (I originally saw it on a pretty questionable site), I could only find it on some rather obviously dubious conspiracy theory sites, plus on the YouTube page of a guy going by "Mr. Ace."

I eventually landed on the hospital's English-language Facebook page, which posted the interview along with some quotes from it in English. However, that video did not have the English subtitles, hence my suspicion. (The Curmudgeon has a rule: if I can't verify it, I can't believe it. Of course, that doesn't mean it isn't true. But it earns bonus suspicion points if it appears on a lot of questionable sites.)

The subtitles say that the doctor is claiming that the vaccines' effectiveness is waning, hence the breakthrough infections in Israel. Now, even if he never said that, I will say that I have confirmed that Israeli officials have approved a third booster of the Pfizer vaccine, and are encouraging it for those over 60 or who are immunocompromised. However, they acknowledge that they don't know whether the vaccine's effectiveness is actually waning, or whether it's just not as effective against the Delta variant as against previous variants, so they're willing to give the booster a shot (pun intended). They also have stated that even absent the booster, the severity of illness among the vaccinated is much less than among the unvaccinated.

But in Israel, there aren't very many of those left. Like Massachusetts, Israel has a very high vaccination rate. They got an early start in their vaccination program, and they had mandatory vaccines for students as a requirement to sit for exams in the Spring (something I also don't agree with). Nearly 60% of the population is fully vaccinated. So again, the math is going to follow the pattern noted above.

A recent study published in the New England Journal of Medicine found a 2.6% breakthrough infection rate among fully vaccinated Israeli healthcare workers. Of those, two-thirds were mild and a third were asymptomatic, although, among the elderly who have been hospitalized in Israel, there have been serious breakthrough infections. Still, a 2.6% breakthrough rate is pretty low.

As early as June, the Israeli health minister noted that about half of infections were occurring in vaccinated individuals. At that time, 85% if Israeli adults were vaccinated. The graphic below illustrates how 50% of cases among vaccinated individuals can be distorted given that high a vaccination rate:

Each circle represents one person assuming a hypothetical population of 100, with a vaccination rate of 85%. Two of the vaccinated people got infected, and two of the unvaccinated people got infected, so yes, 50% of the infections were among the vaccinated population. What that statistic doesn't reveal is that the infection rate among the vaccinated was only 2/85, or 2.3% (not dissimilar to the NEJM study's finding), while the infection rate among the unvaccinated was 2/15, or 13.3%. In other words, the infection rate among the unvaccinated is about six times higher than among the vaccinated.

I'm going to pull a Jen Psaki and circle back to the Israeli government's decision to recommend a third booster dose. The CDC doesn't recommend that, not that we can trust their guidance much. Nor does Pfizer yet, even though they have a financial incentive to do so. So maybe Israel is onto something; maybe they know something we don't know. Or maybe they're just throwing a dart here (pun intended again). Too soon to tell. But even they admit that they can't conclusively say the vaccine's effectiveness is waning - they're hoping that if it's not that, if it's just that the efficacy against Delta isn't as high (and we've seen that to be true), another shot can't hurt.

The UK.

You may have heard of Alex Berenson. He's been making the rounds on some cable shows. He's written some booklets on covid, related to the ineffectiveness of the lockdowns, the inaccuracies of death count reporting, and the ineffectiveness of masks. He's also written about vaccines.

Now Berenson is a novelist, of the spy genre, which I'm keen on. I've been reading his stuff since long before the Wuhan lab engineered covid. He has degrees in history and economics, and he used to write for The Street.com, which was founded by CNBC's Jim Cramer. I like Cramer, and I follow The Street. I also agree with much of what Berenson has had to say about lockdowns, death count reporting, and masks. But I have to part ways with him on his vaccine "analysis." Not because I'm a vaccine advocate. But because his math is flawed. And let's not forget that, by trade, he's a writer of fiction, not a researcher.

I'm not going to go back and find the Twitter post where he talked about the UK data, but it was very similar to the Israel data: he "found" that breakthrough infections accounted for about the same number of recent cases as infections among the unvaccinated. And he used that to conclude that the vaccines were ineffective.

But the UK also has a very high vaccination rate: 58.8% of the population fully vaccinated. So when I applied the math to his data, I found that the infection rate among the vaccinated was quite low compared to the infection rate among the unvaccinated, as illustrated above.

Now, let's look at some data from a place where the vaccination rate is low: Southwest Missouri. I'm picking this area because a) it's been a recent hotspot for infections and hospitalizations, and b) I personally know people who work in the two main hospitals in Joplin, Missouri.

Joplin straddles two counties: Newton and Jasper. In the month of July, those two counties had 2,379 covid cases. Compare that to the 469 cases from the Provincetown study. The two counties have a combined population of 179,654. So the infection rate was 1.3% of the population. 

As of July 31, 17.9% of the population of Newton County was fully vaccinated, and 33.6% of the population of Jasper County was fully vaccinated. A local news article interviewed officials from both major hospitals in Joplin, and both reported that 92-94% of hospitalizations were among the unvaccinated. They also noted that those hospitalized who were vaccinated had less severe cases and were discharged earlier.

Now, this is important: if the hospitalizations among the vaccinated are less severe, logic would tell us that the cases overall among the vaccinated are less severe. Thus you'd have fewer hospitalizations overall among the vaccinated. So if 93%, on average, of hospitalizations, are unvaccinated, then it may not be a stretch to say that 97% of all cases - hospitalized, not hospitalized but symptomatic, and asymptomatic - are among the unvaccinated.

But who really cares? The number, averaged across the U.S., with its average vaccination rate of just over 50%, is likely north of 90% among the unvaccinated, especially since many of the 21 states whose rates are above the national average aren't very populous. In the states with the highest vaccination rates, the number will be below 90% due to the math explained above; as we approach 100% in a given location, we'll approach 100% breakthrough infections. In states with very low vaccination rates, like Alabama, you're probably close to 99%.

Again, who cares? As I said before, I'm adamantly opposed to vaccine shaming. But I'm equally opposed to spreading misinformation just because it aligns with one's preconceived notions - because it purports to prove what one desperately wants it to prove. Don't want to get vaccinated? I wholeheartedly support your choice. Just don't use flawed "analysis" propped up by bad math to try to convince the world that your decision is rooted in "evidence" that the vaccines are ineffective. The math proves that they are - but you're still free to choose not to get one. You think the guys who choose not to wear motorcycle helmets post articles on Facebook claiming scientific evidence that they're not effective in preventing brain injury in a crash? No. They know that they are. They just make a personal health choice that is their right to make (where the law allows).

Let me also say that I do not believe that this spreading of misinformation is always willful or wanton. Sometimes, it's just that those who share it want so much to believe the narrative, to believe that there is scientific justification for their decision to not get vaccinated, that they latch onto anything that aligns with their pre-conceived notions, without questioning it. And maybe they don't understand the math well enough to question it in the first place. They think they've found a smoking gun.

But others see themselves as right-fighters, and do share the misinformation willfully and wantonly (not that they understand that it's misinformation, mind you - they just don't get the math). They decry the vaccine crusaders, while they crusade against the vaccines. They criticize those who would infringe upon the rights of those who make their own private health choice to not get vaccinated, while they attempt to influence the rights of those who might make the private health choice to go ahead and get the vaccine, by plying them with flawed information fueled by bad math. Just leave everybody alone, already, and let them make their own choice, just as you want to be free to make your own choice. You want to be a right-fighter? Fight for that.

One final bit of evidence that I alluded to earlier, related to the difference between cases in the vaccinated vs. the unvaccinated: in July, Massachusetts, with its 64% vaccination rate, had about 10,000 covid cases among its 6.9 million citizens. Missouri, with its 42% vaccination rate, had more than 50,000 cases - more than five times as many - among its 6.1 million residents.

The Truth, the Whole Truth, and Nothing But the Truth

Let's get straight to it. This data comes directly from the CDC. Everybody's been looking at daily data or cumulative data related to Covid, but I fear they've been missing the picture, so I decided to look at monthly data. The CDC doesn't, so for cases I had to aggregate their daily data, and for deaths I had to aggregate their weekly data. (And that means that, if the week didn't end exactly on the last day of the month, I may be picking up some deaths in, say, May 2020 that actually occurred in the first couple of days in June 2020; however, over time those differences will average themselves out, and in any event they're relatively small, statistically speaking.)

First, cases. And I want you to note that the mask mandates were largely put in place last June and July. So how did that work from October through January?

And how effective do you think it's going to be now? Yes, thanks to the Delta variant, cases in July were up - there's that 246% increase in just one month! that the media has been screaming about.

Yes. From the lowest level since March 2020, when "14 days to flatten the curve" began. The July total is 75% of that of April 2021, and nobody's hair was on fire then. It's 70% of the level from July 2020, when most states first put mask mandates in place (which, again, were wholly ineffective; what's the definition of insanity again?).

Still, I concede that, due to the higher viral load of the Delta variant, cases are up. (But as I've previously noted, in India and the UK, Delta cases peaked about 55-90 days in, then began to drop precipitously. We're about 45 days into the Delta spread here, with a far higher vaccination rate than India's, closer to the UK's. So it's not unreasonable to expect that we may be about 10 days from peaking.)

But even if we aren't - what about deaths?

July's total deaths - right in the midst of the Delta spike in cases - was the lowest since March 2020. We got our first big spike in April of last year, when Andrew "McFeely" Cuomo was sending infected octogenarians from the hospital back into the nursing homes. Then we got a bigger spike in the winter months, when cases mushroomed and the much more lethal Alpha variant was dominant. (Note that April through Inauguration Day was also the period when every U.S. death was labeled a Covid death. If you got hit by a bus, and tested positive post-mortem for Covid, you died of Covid. Same for drowning, drug overdoses, etc. And that's also when hospitals were getting a CARES Act bonus for every Covid death, so they were moving every patient from palliative care into the Covid wing so they could cash in. Never mind that that meant their loved ones couldn't hold their hands as they passed. And the medical profession wonders why Americans no longer trust them.)

But folks, since May of this year, the pandemic - if you define it as a wave of life-threatening illness - has been over. If you define it as a virus that might cause a bunch of people to get sick, like the flu or the common cold, well, okay, it's a pandemic. And by that definition, we may get a new pandemic pretty much every year.

So what do these numbers equate to in terms of Case Fatality Rate (deaths divided by cases)? Here's where the data is really telling.

See, the cumulative CFR is misleading. It's misleading, because even when cases and deaths spiked last December and January, the CFR was low. Deaths averaged more than 100,000 per month in each of those two months. But the CFR averaged just 1.8%. The cumulative CFR is 1.7%.

Now, why was it so high in January 2020? Remember the first outbreak was in a Washington nursing home. Concentrated in an at-risk population. Doctors didn't know what this thing was or how to treat it. And, the numbers are too small to be statistically significant - six deaths out of 51 cases. Again, the CFR spike in April can be traced largely to the New York nursing home deaths.

So what's the CFR in the month of the "deadly" Delta variant spike?

0.4%.

One-third the rate of any previous month. Much lower than the seasonal flu.

"Oh, but there's a lag," the fearmongers warn.

BS. The lag is less than a month. We'd have seen it by now. Remember, I had to aggregate this data from daily and weekly numbers. I saw no uptick in the weekly deaths in July. In fact, in the last week of the month, deaths fell by 40% from the previous week, even as cases spiked sharply as the month progressed. And, it's not what we saw in the UK: even as cases spiked to near-record levels, deaths remained flat throughout. So the "lag" argument is hogwash.

The data is clear, and it's unfiltered, straight from the very source that is spreading hysteria and issuing guidance that is leading to a return to state and local despots overreaching their authority. Be smarter this time. Look at the data. And tell the despots what they can do with their mandates.